Prins M, Bindels P J, Coutinho R A, Henquet C J, van Doornum G J, van den Hoek J A
Department of Public Health and Environment, Amsterdam, The Netherlands.
Genitourin Med. 1994 Aug;70(4):247-52. doi: 10.1136/sti.70.4.247.
At the STD clinic of the Municipal Health Service in Amsterdam, the annual number of infections with penicillinase-producing Neisseria gonorrhoeae (PPNG) strains remained relatively stable from 1983 until 1990, while the number of non-PPNG infections declined dramatically. To investigate the PPNG and non-PPNG epidemic, a cross sectional study was conducted in 1989 and 1990. The purpose of this study was to assess determinants of PPNG infections among heterosexuals diagnosed with gonorrhoeae.
In addition to routinely collected data in new consultations for STDs, information on alcohol use, drug use and sexual behaviour was obtained from patients diagnosed with gonorrhoea. The diagnosis of gonorrhoea was based on a positive culture and isolates were screened for PPNG. Logistic regression analysis was used to assess independent predictors of PPNG infection.
Additional information was available of 328 women and 995 heterosexual men diagnosed with gonorrhoea. PPNG was diagnosed in 86/328 (26%) women and in 329/995 (33%) men. Logistic regression analysis identified a Central/South American nationality (odds ratio(OR) = 2.46) and older age (OR = 1.04 per year) as positively associated with PPNG infection in female patients. An inverse relation was found with use of hard drugs (OR = 0.29). Among men diagnosed with gonorrhoea, sexual contacts with window prostitutes (mainly women from Central/South America) (OR = 1.98) and a foreign nationality (OR = 1.78) were positively associated with PPNG infection, and sexual contact with drug using prostitutes (OR = 0.47) inversely.
PPNG infections were especially common among Central and South American window prostitutes and their clients, but not among hard-drug addicted prostitutes and their clients. Since window prostitutes originating from Central and South American countries are transient in Amsterdam, prevention activities targeted at these prostitutes and their clients should be continued to limit the spread of PPNG and other STDs within these groups.
在阿姆斯特丹市卫生服务中心的性传播疾病诊所，1983年至1990年期间，产青霉素酶淋病奈瑟菌（PPNG）菌株的年感染数相对稳定，而非PPNG感染数则急剧下降。为调查PPNG和非PPNG的流行情况，于1989年和1990年开展了一项横断面研究。本研究的目的是评估确诊为淋病的异性恋者中PPNG感染的决定因素。
除了在性传播疾病新诊病例中常规收集的数据外，还从确诊为淋病的患者那里获取了有关饮酒、吸毒和性行为的信息。淋病的诊断基于培养阳性，对分离株进行PPNG筛查。采用逻辑回归分析评估PPNG感染的独立预测因素。
获得了328名确诊为淋病的女性和995名异性恋男性的额外信息。86/328（26%）的女性和329/995（33%）的男性被诊断为PPNG感染。逻辑回归分析确定，中南美国籍（优势比[OR]=2.46）和年龄较大（每年OR=1.04）与女性患者的PPNG感染呈正相关。发现与使用硬性毒品呈负相关（OR=0.29）。在确诊为淋病的男性中，与站街妓女（主要是来自中南美的女性）发生性接触（OR=1.98）和外国国籍（OR=1.78）与PPNG感染呈正相关，与吸毒妓女发生性接触则呈负相关（OR=0.47）。
PPNG感染在中南美站街妓女及其嫖客中尤为常见，但在吸毒成瘾的妓女及其嫖客中并不常见。由于来自中南美国家的站街妓女在阿姆斯特丹是流动的，针对这些妓女及其嫖客的预防活动应继续开展，以限制PPNG和其他性传播疾病在这些群体中的传播。
